Postoperative Regional Scalp Block versus Intravenous Fentanyl for Postsupratentorial Craniotomy Analgesia in Adult Patients under General Anesthesia

Abstract

Majority of patients undergoing experienced moderate to severe pain in surgical site after the procedure, and there is a reluctance to manage this pain with systemic that is understandable as it may impair neurological assessment, that is crucial in the postoperative period. In addition to that, evidence concerning alternative analgesia techniques to manage post pain is deficient. This research aims at evaluating the effect of postoperative regional scalp block (RSB) versus intravenous for analgesia in adult patients under general . Patients were automatically divided into two groups with 15 patients in each, Group B: postoperative RSB was done after the end of skin closure and before emergence from general , Group C: control group: in which standard analgesia was given in the form of intravenous with no block. This study included patients with brain were admitted to Zagazig University Hospitals. We gathered the cases in the time between March 2018 and March 2020. Results: the results displayed highly significant differences between RSB group and control group. Postoperative RSB showed advantages over standard analgesia in the point of more significant reduction of response to pain in the form of heart rate and blood pressure , decrease consumption, lower Visual Analogue Score(VAS), Postoperative RSB can be performed easily in a short time with very high success rate allowing better postoperative control of , less postoperative pain. We recommend using postoperative RSB in as a gold standard in our hospital to get the advantages as mentioned above.

Scalp Nerve Block, Local Anesthetic Infiltration, and Postoperative Pain After Craniotomy: A Systematic Review and Network Meta-analysis of Randomized Trials

“…A total of 24 randomized trials were included in the final analysis. 11,12,[16][17][18][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] Characteristics of the Individual Studies Among the 24 eligible studies, 13…”

“…After a detailed review of the full-texts, 5 publications were excluded due to ineligible interventions, 4 were excluded due to ineligible patient populations, and 3 were excluded due to ineligible outcome measures (Supplemental Digital Content 2, http://links.lww.com/JNA/A541: Characteristics of excluded studies). A total of 24 randomized trials were included in the final analysis 11,12,16–18,32–49 …”

“…Moreover, additional randomized controlled trials have been published since these previous reviews. 11,12,[16][17][18] An updated review differentiating the SNB/ SI methods was needed.…”

“…However, these reviews did not specifically distinguish different methods of SNB and SI, especially the different drugs used in the injection solution. Moreover, additional randomized controlled trials have been published since these previous reviews 11,12,16–18 . An updated review differentiating the SNB/SI methods was needed.…”